For Employees

Employee Services

HR Forms

• Access Card/ID Badge Payroll Deduction Form
• Address and Name Change Form
• Authorization for Accounts Payable Direct Deposit
• Authorization for Payroll Direct Deposit
• Background Information Disclosure Form
• MI Withholdings
• Parking Registration
• Quickcharge Payroll Deduction Agreement
• W4-Federal Withholding Form 2012
• WI Withholdings

Benefit Forms

• 401k Beneficiary Form
• 401k Distribution Form
• 401k Payroll Deduction Change Form
• Flexible Spending Claim Form
• Life Insurance Beneficiary
• Vision Insurance Claim Form

Employee Health Forms

• Family Medical Leave/Short Term Disability Application
• Employee Assistance Program Brochure
• Tuberculosis (TB) Signs and Symptoms Review
• TB Skin Test Record
• TB Risk Levels by Department
• Authorization to Release Protected Health Information
• Employee Incident Report

Wellness Programs

• Fitness Reimbursement Program Packet
• Anytime Fitness Offer for BAMC Employees
• Peshtigo Fitness Center Offer for BAMC Employees
• YMCA Member Information
• YMCA Membership & Policies
• YMCA Two Week Free Trial
• YMCA Winter Classes - 2011
• River Cities Community Pool Brochure
• Curves Offer for BAMC Employees
• Curves - Zumba Classes
• Team BAMC Dates

Flu Shot Clinics

• 2011-2012 Inactivated Influenza Vaccine Information Sheet
• Declination of Seasonal Influenza Vaccination

Respiratory Fit Testing Forms

• Qualitative Fit Test Record
• Respirator Medical Evaluation Questionnaire
• 3M Respirator Training and User Instructions
• Kimberly-Clark Respirator Training and User Instructions
• Respirator Training Post Test
• Respirator Fit Testers
• Respirator Fit Testing Risk Levels by Department

Education Forms

• Bay Area Medical Center Employee Tuition Discount
• Bay Area Medical Center Employee Tuition Discount at Rasmussen College
• Education Reimbursement Form
  Mileage rates:
  1/1/2011 to 6/30/2011: .51 cents/mile
  7/1/2011 to current: .555 cents/mile
• Epic video

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